γ-羟基丁酸钠用于心肺转流下二尖瓣狭窄病人的药代动力学

Pharmacokinetics of sodium γ-hydroxybutyrate in patients with mitral stenosis operated under cardiopulmonary bypass

目的 检测γ 羟基丁酸钠 (γ OH)用于心肺转流 (CPB)下二尖瓣狭窄成年病人的药代动力学参数。方法 8例二尖瓣狭窄成年病人 ,CPB前和CPB后各一次静注γ OH70mg/kg ,以气相色谱法检测各时点γ OH的血浆浓度。结果 CPB下γ OH的药代动力学模型为开放性二室模型。非心脏手术时全麻成人t1/ 2 β为 (85 10± 2 8 80 )分钟 ,CL为 (2 6 6 0± 0 983)ml·kg-1·min-1,而心脏病成人CPB下t1/ 2 β为 (172 6 30± 5 3 74 3)分钟 ,延长约 1倍 ,CL为 (1 5 5 9± 0 5 74 )ml·kg-1·min-1,显著降低 (P <0 0 1)。与CPB前的血药浓度下降速度相比 ,CPB开始后血药浓度下降速度明显减慢(P <0 0 1)。结论 CPB下γ OH的分布相、消除相均延长 。

Objective To study the pharmacokinetics of sodium γ hydroxybutyrate(γ OH) in patients with mitral stenosis(MS) operated under cardiopulmonary bypass(CPB).Methods Eight adult patients with MS were studied.Plasma γ OH concentrations after intravenous injection of γ OH 70mg/kg pre and post CPB respectively were assayed by gas chromatography.Results The kinetics could be described by open two compartment model.The adult patients with MS had the longer t 1/2β (172 630±53 743)min and lower CL(1 559±0 574)ml·kg -1 ·min -1 than γ OH pharmacokinetics parameters of non cardiac patients [t 1/2β =(85 10±28 80)min,CL=(2 660±0 983)ml·kg -1 ·min -1 ].During CPB,the decrease in plasma γ OH concentration became smaller than that pre CPB.Conclusion The distribution phase and elimination phase of γ OH are lengthened by CPB.The pharmacokinetics of γ OH in adult patients undergoing cardiac surgery with CPB are dissimilar from those reported for other adult patient population. [